Kornimate/medical-research-clean huggingface dataset:
assesment of muscular unloading in chronic obstructive pulmonary disease (copd) patients with niv

Conditions: COPD

Summary: evaluation of high intensity nimv in terms of physiological parameters has been performed in short-term studies in copd patients. however, the support pressure levels used in exacerbated patients seem contradictory and the muscular unloading levels are uncertain. the objective of study is to determine the discharge level of the inspiratory musculature reached at the same pressure support (ps) values in a group of hospital and domiciliary ventilators. patients with copd in at least 6 months of treatment with home nimv and in stable phase of their disease will be included. eight commercial ventilators will be used, each patient will use 2 different ventilators. a 5 minute record will be taken at baseline (without nimv). subsequently, 5 minutes in nimv in 3 levels of ps (15/10/20) for each ventilator (15/10/20) and patient with expiratory positive airway pressure (epap) of 5 centimeters of water (cmh2o) will be recorded. the results will be compared between the different ventilators and ps values using a general linear model for repeated variables to determine the differences between ventilators and ps levels of respiratory muscular unloading in copd patients


Eligibility criteria:
inclusion criteria: * patients with copd diagnoses based on a spirometry performed the previous year during stability. * copd patients with home niv treatment of at least 6 months with acceptable compliance and adaptation. * stable patients or just before hospital discharge due to an exacerbation with gasometric stability. exclusion criteria: * respiratory acidosis in blood gas analysis, just in case of recent exacerbation * patients with restrictive pathology and /or obesity (imc\>35) * poor quality of emg signals.

Keywords: monitoring niv, inspiratory muscular unloading, emg
dialectical behavior therapy for adolescents with self-harm and suicidal behavior- an open trial

Conditions: Self-harm; Suicidal Ideation; Suicide and Self-harm

Summary: the goal of this pre-post-follow-up study is to examine how well the treatment dialectical behavior therapy for adolescents (dbt-a) with a duration of 20 weeks for adolescents with self-harm and suicidal behavior works in routine clinical practice. the main questions it aims to answer are: * to investigate how well dbt-a works after treatment and at 3-month follow-up, measured by episodes of self-harm, suicide attempts, depressive symptoms and quality of life, drop-out from treatment and number of possible participants who decline dbt-a. * to investigate how well dbt-a works at 12 months follow-up * to investigate whether pre-treatment factors can predict who will benefit from treatment

self-harm and suicidal ideation are prevalent among adolescents and associated with major mental health problems and adverse life events. dialectical behavior therapy for adolescents (dbt-a) is an empirically supported treatment for self-harm and suicidal ideation in adolescents. however, knowledge is scarce on the effectiveness, long-term outcomes, acceptability, and dropout of dbt-a when implemented and delivered as part of routine clinical practice in the norwegian national health care system. the main aim of this study is to examine the outcomes from dbt-a in terms of self-harm episodes, suicide attempts, and emergency hospital admission, in addition to acceptability and dropout, when dbt-a is delivered at the department of child and adolescent psychiatry (pbu), haukeland university hospital (hus). the study is an uncontrolled pre-post study with one-year follow-up and includes three aims: to evaluate outcomes of dbt-a up to three months post-treatment, at one-year follow-up, and to describe predictors of outcome for adolescents receiving dbt-a.

Eligibility criteria:
inclusion criteria: * age 13-18 years * ongoing or a history of self-harm the last six months; current suicidal behavior (suicidal thoughts or at least one suicide attempt within the previous six months); at least three criteria of diagnostic and statistical manual -5 (dsm-5) borderline personality disorder (bpd), or the self-destruction criterion of dsm-5 bpd in addition to minimum two subthreshold criteria as assessed by the structured clinical interview for dsm-5 personality disorders (scid-5-pd) (first et al., 2016) * fluency in norwegian * one parent/trusted adult that can participate together with the adolescent. exclusion criteria: * intellectual disability * significant learning or language impairments * autism spectrum disorder * anorexia nervosa * any psychotic disorder * substance abuse disorder. these patients will be offered treatment as usual at their local outpatient clinic.

Keywords: suicide and self-harm adolescents dialectical behavior therapy for adolescents routine clinical practice effectiveness study
burosumab and 1-25 (oh) vitamin d on human osteoblasts

Conditions: Craniosynostoses

Summary: fgf23 is the cornerstone of phosphate / calcium / vitamin d metabolism: it is synthesized mainly by osteocytes and acts as a phosphaturizing agent, inhibitor of dihydroxyvitamin d, and inhibitor of synthesis and secretion of pth in most tissues. the specific role of fgf23 on bone has yet to be demonstrated. in osteoblasts, overexpression of fgf23 in vitro suppresses not only osteoblastic differentiation but also the synthesis of the mineralized matrix independently of its systemic action on phosphate metabolism. in osteoblasts, fgf23 also regulates the secretion of osteopontin by directly suppressing transcription of alkaline phosphatase. in some diseases such as hypophosphatemic rickets (hr), the direct role of fgf23 on bone has not yet been studied to our knowledge, whereas these genetic hypophosphatemias are secondary to overexpression of fgf23, whether an activating mutation of fgf23 or inhibitory mutations of its inhibitors (dmp1 and phex). however, patients with x-linked hypophosphatemic rickets (xlh) have higher circulating fgf23 levels than healthy controls and these levels are higher in treated patients. management of xlh consists primarily of correcting the native vitamin d defect by prescribing active vitamin d analogs as well as phosphate supplementation to improve bone mineralization and decrease dental complications, growth, and bone deformities. recently, a new therapeutic option has been developed for xlh, burosumab, a human monoclonal antibody that binds and inhibits fgf23 activity. the use of burosumab is currently authorized in france in some pediatric patients with severe forms of xlh. independently of the indirect bone effects of phosphate correction and vitamin d levels, the direct role of burosumab on bone cells has never been studied. the objective of this project is to study the osteoblastic biology of patients with rh compared to control patients, and to evaluate the direct impact of the treatments used in this pathology on human osteoblasts.


Eligibility criteria:
inclusion criteria: * children from 4 months-old to 18 years-old * patients requiring craniosynostosis surgery followed by reference centers for rare diseases of calcium and phosphate metabolism / craniofacial malformations * patients and parent / holder of parental authority who have been informed of the study and do not object to participate exclusion criteria: * patient being treated with oral corticosteroid or having received more than 3 months of corticosteroid treatment before surgery.
multicenter comparison of fluconazole (uk-49,858) and amphotericin b as treatment for acute cryptococcal meningitis

Conditions: Meningitis, Cryptococcal; HIV Infections

Summary: to compare the safety and effectiveness of fluconazole and amphotericin b, alone or in combination with flucytosine, as treatment for acute cryptococcal meningitis.


Eligibility criteria:
inclusion criteria concurrent medication: allowed: * immunosuppressant therapy. * antiviral such as zidovudine. * radiation therapy for mucocutaneous kaposi's sarcoma. * prophylaxis for pneumocystis carinii pneumonia (pcp) including aerosol pentamidine. concurrent treatment: allowed: * radiation therapy for mucocutaneous kaposi's sarcoma. written informed consent must be obtained for each patient, either from the patient himself or from the patient's legal guardian. * no prior systemic antifungal therapy for cryptococcosis. * relapse after prior therapy. * success of prior therapy must have been documented by negative cerebrospinal fluid (csf) culture at the end of therapy. following prior therapy, such patients may not have received more than 1 mg/kg/wk amphotericin b in the 4 weeks before entry into study. prior medication: allowed: * immunosuppressant therapy. * antivirals such as zidovudine (azt). * prophylaxis for pneumocystis carinii pneumonia (pcp) including aerosol pentamidine. exclusion criteria co-existing condition: patients with the following are excluded: * evidence of acute or chronic meningitis based upon any etiology other than cryptococcosis. * history of allergy to or intolerance of imidazoles, azoles, or amphotericin b. * moderate or severe liver disease. * comatose. * unlikely to survive more than 2 weeks. * any exceptions to these prohibitions of concomitant medications must be approved by pfizer central research. concurrent medication: excluded: * coumadin-type anticoagulants. * oral hypoglycemics. * barbiturates. * phenytoin. * immunostimulants. * investigational drugs or approved (licensed) drugs for investigational indications. * any exceptions to these prohibitions of concomitant medications must be approved by pfizer central research. * excluded within 4 weeks of study entry: * received more than 1 mg/kg/wk amphotericin b. concurrent treatment: excluded: * lymphocyte replacement. patients with the following are excluded: * evidence of acute or chronic meningitis based upon any etiology other than cryptococcosis. * history of allergy to or intolerance of imidazoles, azoles, or amphotericin b. * moderate or severe liver disease. * comatose. * unlikely to survive more than 2 weeks. prior medication: excluded: * coumadin-type anticoagulants. * oral hypoglycemics. * barbiturates. * phenytoin. * immunostimulants. * investigational drugs or approved (licensed) drugs for investigational indications. * excluded within 4 weeks of study entry: * more than 1 mg/kg/wk amphotericin b. prior treatment: excluded: * lymphocyte replacement.

Keywords: aids-related opportunistic infections meningitis cryptococcosis drug therapy, combination fluconazole flucytosine acquired immunodeficiency syndrome amphotericin b
comparison of postoperative analgesic efficacy of spsipb and combination of ibpb and scpb

Conditions: Shoulder Arthroscopy; İnterscalene Brachial Plexus Block; Superficial Cervical Plexus Block; Serratus Posterior Superior Intercostal Plane Block

Summary: shoulder arthroscopy is one of the frequently performed surgical procedures today. after shoulder surgery, ensuring sufficent analgesia is necessary for both the patient's comfort and for the early and regular performance of the required postoperative rehabilitation exercises. nerve blocks provide better pain control, opioid consumption in the postoperative period, and consequently have advantages such as fewer side effects and lower risks of pulmonary and cardiac complications. multimodal analgesia approach is preferred for patients undergoing shoulder arthroscopy. along with intravenous analgesic agents, peripheral nerve blocks (applied to every suitable and consenting patient) are performed based on patient preference. this study aims to compare the analgesic efficacy in the postoperative period of patients undergoing shoulder arthroscopy with a combination of interscalene brachial plexus block and superficial cervical plexus block with serratus posterior superior intercostal plane block.


Eligibility criteria:
inclusion criteria: * 18 to 65 years old * american society of anesthesiologists (asa) physical status i-ii-iii * body mass index 18 to 30 kg/m2 * elective shoulder arthroscopy surgery exclusion criteria: * under 18 and over 65 * asa score iv and above * advanced co-morbidity * history of bleeding diathesis * bmi under 18 kg/m2 and over 30 kg/m2 * patient refusing the procedure * patients who have previously undergone shoulder surgery * chronic opioid or analgesic use * patients who will operate under emergency conditions * patients who will not undergo shoulder surgery

Keywords: remifantanile conception acute pain postoperatif pain
endoscopic radiofrequency ablation versus hybrid argon plasma coagulation in the treatment of barrett's esophagus

Conditions: Barrett Esophagus; Esophageal Adenocarcinoma; Reflux Disease

Summary: this study compares patients' acceptability and safety of two established endoscopic methods for treating dysplastic barrett's esophagus: radiofrequency ablation versus hybrid argon plasma coagulation.

both endoscopic radiofrequency ablation (rfa) and argon plasma coagulation (apc) are established treatment modalities for dysplastic barrett's esophagus. recently, a modification of the apc method has emerged, which involves a submucosal injection of saline preceding the thermal ablation (hybrid-apc; h-apc). this allows to increase the procedure's safety and presumably reduces the patients' post-procedural discomfort. although both rfa and h-apc are characterized by high effectiveness in eradicating barrett's segments, limited data compares the patient-related aspects of the procedures. to fill this knowledge gap, we set out a single-center randomized-controlled trial to compare procedural acceptability, safety, and impact on the quality of life, of the two methods.

Eligibility criteria:
inclusion criteria: * male or female subjects over 18 years * histologically and endoscopically proven barrett's esophagus requiring ablation therapy according to the current guidelines * general health status sufficient to perform an endoscopic procedure (asa i-iii) exclusion criteria: * primary or secondary coagulopathy, with inr\>1.5 and/or platelet count of \<75,000. * anticoagulation therapy (e.g. warfarin) for high-risk condition and unable to withhold the medication temporarily * recent myocardial infraction or other significant cardiovascular event within 6 months prior to recruitment * patients under long-term care and/or within nursing facilities (e.g. psychosocial disorders, mental retardation) * any history of esophageal resection surgery * esophageal varices
how does hemodynamic regulation affects graft functions during renal transplantation?

Conditions: Renal Transplant Failure and Rejection; Hypotension

Summary: the aim of the researchers was to evaluate the adequacy of graft function in the postoperative period of patients who underwent renal transplantation and encountered hypotension in the intraoperative period.


Eligibility criteria:
inclusion criteria: * patients undergoing renal transplantation exclusion criteria: * patient refusal
aerobic interval training in patients with atrial fibrillation

Conditions: Atrial Fibrillation

Summary: the purpose of this study is to determine the effect of aerobic interval training in patients with paroxysmal or persistent atrial fibrillation, especially to see if the burden of atrial fibrillation and symptoms are reduced.

long term endurance sport practice is associated with a higher incidence of atrial fibrillation. moderate/light physical activity seems to be associated with a lower incidence. the underlying mechanisms are uncertain. in order to examine the effect of training in this population, the investigators will perform a randomised controlled study with aerobic interval training in patients with paroxysmal/persistent atrial fibrillation.

Eligibility criteria:
inclusion criteria: * patients with paroxysmal or persistent atrial fibrillation, that are able to perform aerobic interval training. exclusion criteria: * performing high intensity training (pulse \>90% of max) for more than 2 times a week. * moderate intensity training more than 30 min, more than 3 times a week * previous open heart surgery * ef \<40% * significant aorta stenosis * mitral insufficiency, \>gr. 2 * pacemaker * earlier coronary intervention and not complete revascularization

Keywords: atrial fibrillation motor activity
the effect of using sticky bone with coronally advanced flap in management of type 1 gingival recession

Conditions: Gingival Recession, Localized

Summary: the main goal of this clinical trial is to evaluate the effect of sticky bone with coronally advanced flap in management of gingival recession in comparison to coronally advanced flap alone


Eligibility criteria:
inclusion criteria: 1. selected patients of both sexes with age range 25-45 years old. 2. patients are systemically healthy based on questionnaire dental modification of cornell index. 3. o'leary index (1972) is less than 10% (the surgical therapy is not initiated until the patient reaches the 10% level or less of plaque accumulation). 4. buccal recession defects are classified rt1 according to cairo's classification (2011). 5. clinical indication and/or patient request for recession coverage. exclusion criteria: 1. pregnant female. 2. smokers. 3. patients with special needs or with any mental problems. 4. all patients are using any kind of medications that could interfere with healing of periodontal tissues. such as chemotherapy and radiotherapy. 5. teeth with carious lesions. 6. rotated and extruded teeth. 7. patient undergone any prior periodontal surgery in the relevant region within year.
bioelectrical impedance analysis in estimating body composition in patients with stage i-iv head and neck cancer undergoing radiation therapy

Conditions: Head and Neck Carcinoma

Summary: bioelectrical impedance analysis measures body mass (the amount of muscle and fat in the body) and the level of hydration to help researchers identify patients who are losing muscle mass during radiation therapy. this information may help researchers make decisions about nutritional supplementation and the placement of feeding tubes in patients receiving radiation therapy.

primary objectives: i. to validate body composition estimates derived from the seca (seca) medical body composition analyzer (mbca) bioelectrical impedance analysis (bia) scale by comparing with computed tomography (ct) measured lean and fat body mass. secondary objectives: i. evaluate sensitivity of mbca to detect changes in body composition during treatment. ii. identify whether bia-estimated loss of lean body mass (lbm) during treatment predicts development of sarcopenia. iii. determine whether bia-derived estimates of body water correlate with requirements for intravenous (iv) hydration and unplanned hospital admissions. iv. explore associations between body composition and symptom burden during treatment. outline: patients undergo bioelectrical impedance analysis with seca mbca and ct or positron emission tomography (pet) at baseline, weekly for 6-7 weeks during standard of care radiation therapy (rt), and at 10-12 weeks after completion of rt. after completion of study, patients are followed up every 3 months for 2 years.

Eligibility criteria:
inclusion criteria: * histologically documented head and neck cancer (clinical stage i-ivb; tx,1-4, n0-3). * patients dispositioned to receive radiation therapy (dose \>= 60 gray \[gy\]). * patients may receive radiation as either primary therapy or post-operatively. * patient received staging positron emission tomography/computed tomography (pet/ct) scan during 60-day period prior to initiating therapy. * negative pregnancy test for women of child bearing potential. exclusion criteria: * previous radiation treatment for head and neck mucosal primary cancers (i.e. oropharynx, nasopharynx, hypopharynx, larynx, and oral cavity). * patients with pacemaker, implanted cardiac defibrillator, or vagal nerve stimulator. * pregnant or breast-feeding females. * patients weighing over 660 lbs (300 kg). * patients with other medical conditions known to cause sarcopenia, including new york heart association (nyha) class iii-iv heart failure, oxygen-dependent pulmonary disease, advanced human immunodeficiency virus infection, cirrhosis, end stage renal disease, or inherited/congenital disorders of metabolism. * patients receiving palliative irradiation.
factors influencing inclusion in digestive cancer clinical trials

Conditions: Digestive Cancer

Summary: since the early 1990s, evidence-based medicine has played an increasingly important role in decision-making for the treatment of patients with cancer. the highest level of evidence is attributed to the results of randomized comparative studies, and the public health authorities require proof from randomized therapeutic trials before authorizing the use of new treatments. patients included in therapeutic trials benefit either from the best current treatment (control group) or from a treatment supposed to present a better or similar efficacy, together with an extremely rigorous surveillance protocol. inclusion in a randomized therapeutic trial represents the optimal therapeutic strategy.in order to optimize the fight against cancer, french public health policies have led to the progressive implementation of successive nationwide "cancer plans" since 2003. one of the objectives is to increase the proportion of patients included in clinical research trials. thus, the fraction enrolled in france has progressively increased but remained low at around 8% in 2010. the current 2014-2019 plan aims to expand inclusion to 50,000 patients per year. in a context of socio-economic inequalities that concern resources, residence and access to services, identifying factors that determine inclusion in trials will in turn highlight the reasons for non-inclusion. the aim of this study was to determine, at a population level, the influence of demographic characteristics and socio-economic status of patients with digestive cancer on inclusion in a clinical trial. between 2004 and 2010, 4632 patients were recorded by the burgundy digestive cancer registry. according to a balancing score, the 136 patients included in a clinical trial were matched with 272 patients who met the eligibility criteria for trials. deprivation was measured by the ecological european deprivation index. a conditional multivariate logistic regression was performed.


Eligibility criteria:
inclusion criteria: * patient with digestive cancer residing in burgundy, france exclusion criteria: * associated cancer